Healthcare Provider Details

I. General information

NPI: 1013389915
Provider Name (Legal Business Name): MARSHA L GUBSER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARSHA L HENRY

II. Dates (important events)

Enumeration Date: 10/30/2015
Last Update Date: 04/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3451 E 12TH ST
OAKLAND CA
94601-3463
US

IV. Provider business mailing address

1766 CASA GRANDE ST
BENICIA CA
94510-2336
US

V. Phone/Fax

Practice location:
  • Phone: 925-363-2005
  • Fax:
Mailing address:
  • Phone: 707-297-6210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW 76445
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: